PART 1: Comprehensive Goals for Managing HIV Infection

Guest/Cleaning and Rearranging the House

II. To support the body ’s ability to fight chronic,ongoing infection before obvious disease conditions occur,by using key nutrients that help to improve and maintain an adequate immune response.

When leading physicians started recommending early intervention a few years ago, they usually meant starting early with antiviral drugs, including nucleoside analogs such as AZT. In today’s situationwith combination therapy, many questions remain as to when you should start drug therapy, how long you should stay on it, when to switch to other combinations, what the best combinations are and just howdangerous are the side effects and cross-reactions with other drugs. But what is more and more clear is that early intervention with nutrients is, if done wisely, not only good for the body but critical in maintaining health.As University of Miami School of Medicine researcher Richard Beach, MD stated:

The most important message is to start nutri-tional intervention as soon as possible. Unfortunately, our entire orientation in treating the nutritional aspects of HIV infection is directed toward end-stage disease. It is often too late at that point because these patients frequently arrive very depleted in their overall nutritional status. They are already deficient in many different nutrients.

HIV is a chronic infection, one that your body is continuously fighting, even when you feel great.This ongoing fight uses up the body’s store of nutrients, resulting in deficiencies even from the very earliest stages. By restoring those lost nutrients, you help keep your body functioning well, and a better func-tioning body does a better job of keeping the virus at bay.This explains why people who take in enough food and supplements generally have a slower rate of disease progression. More specifically, nutritional intervention can accomplish three things:

1. Restoring immune function, thus helping to control or eliminate pathogens like yeast infections;
2. Slowing and/or altering the course of disease progression;
3. Directly fighting HIV to reduce viral levels.

Several epidemiological studies (studies of how diseases appear or spread) have shown that HIV pro-gressed more slowly in HIVers who took supple-ments or had high nutritional intake than in those who did not. In one study, people who used a single multivitamin saw a 31% decrease in the risk of AIDS developing over the six years of the study along with a 40% reduction in the risk of having a low CD4 T-lymphocyte count.Another report indicated a slow-er progression to AIDS in those who used micronutrients. As the people at Philadelphia Fight put it: What you eat affects your immune system. Although HIV is unpredictable, good nutrition is something you can control. Simply put, people who are malnourished are more likely to get opportunis-tic infections (OIs) or to develop wasting.

Virtually every micronutrient (vitamins and min-erals) is required for some aspect of immune func-tion. A good diet needs to provide bothmicronutrients and macronutrients (carbohydrates, protein, and fats), and also a higher intake of calories that are needed because of the constant demands on the immune system caused by the presence of HIV. As noted by Dr. Lark Lands, a key nutritional counselor and writer specializing in HIV treatment,

Any supplementation aimed at specific symp-toms must be in the context of a complete nutri-tional approach. Nutrients seldom work singly in the body. Rather, they work as a package that, only in whole, effects total body changes such as immunological improvement and symptom elimi-nation.

For a detailed discussion, including doses, routes of administration, best forms, and toxicities, see the Health-Enhancing Nutrient Supplementation section in the Self-Care Guide .For more succinct descriptions, look in the DAAIR Nutraceutical catalog.

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